melphalan and Necrobiosis-Lipoidica

Necrobiotic xanthogranuloma (NXG) is a rare non-X histiocytosis with conspicuous lesions on the periorbital skin.. A diabetic patient presented with NXG and a previous diagnosis of necrobiosis lipoidica on the legs over a period of almost 2 years before the development of the typical lesions of NXG on the periorbital regions, back, thighs and legs. The patient was found also to have developed lambda paraproteinemia.. Treatment with melphalan and prednisone resulted in great improvement of cutaneous lesions and paraproteinemia remission.. This case report details how melphalan and prednisone can be administered in the successful treatment of necrobiotic xanthogranuloma with lambda paraproteinemia.

Topics: Adult; Anti-Inflammatory Agents; Diagnosis, Differential; Drug Therapy, Combination; Female; Histiocytosis; Humans; Melphalan; Necrobiosis Lipoidica; Paraproteinemias; Prednisone

A 66-year-old man with necrobiotic xanthogranuloma associated with paraproteinaemia is described. He also had long-standing normolipaemic plane xanthomata. Treatment was with melphalan 0.15 mg/kg body weight/day. Initially, three 5-day courses were given at 4-weekly intervals but a fourth course was necessary after a further 4 months because of a deterioration in both his skin and associated systemic symptoms.

Topics: Aged; Granuloma; Humans; Hypergammaglobulinemia; Immunoglobulin G; Male; Melphalan; Necrobiosis Lipoidica; Xanthomatosis